The Prognostic Value of Thrombocytopenia in COVID-19 Pneumonia, Gezira Isolation Centers, Sudan

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes novel coronavirus disease 2019 (COVID-19), is spreading rapidly around the world. Thrombocytopenia in patients with COVID-19 has not been fully studied. To date no published works in Sudan describe thrombocytopenia among COVID-19 patients.

Objective: To study the prognostic value of thrombocytopenia in COVID-19 Pneumonia.

Methods: A prospective cross-sectional study enrolled 140 COVID-19 patients in Gezira Isolation Centers during the period from November 2020 to February 2021. Data regarding demographics, clinical presentation, laboratory investigation, mode of oxygen therapy and outcomes were collected. Thrombocytopenia defined when platelets counts less than 150 x 103 cell/cumm.

Results: Among 140 patients, 86(61%) were males and 54(39%) were females, their mean age was 66.5±13.5 years. In outcomes, 91(65%) patients were recovered and 49(35%) were deceased. The mean of platelets count was 246±124 x 103 cell/cumm and 38(27.1%) patients had thrombocytopenia, among them 37(26.4%) patients had platelet count ranged from 51-149 x 103 cell/cumm and one (0.7%) patients had platelet count below 50 x 103 cell/cumm. Thrombocytopenic patients were significantly older than those without thrombocytopenia (70.9±9.1 years vs 64.8±14.4 years; P. value= 0.017). Also, thrombocytopenic patients were more tended to have hypertension (63.2% vs 44.1%; P. value= 0.025), diabetes mellitus (DM; 63.2% vs 43.1%; P. value= 0.024), renal disease (65.8% vs 16.7%; P. value= 0.001), and lung disease (10.5% vs 0%; P. value= 0.041). Moreover, thrombocytopenic patients were more inclined to receive mechanical ventilation (100%) and CPAP (81.8%) more than those without thrombocytopenia (P. value < 0.001). Thrombocytopenia was significantly correlated with mortality (67.3% vs 5.5%; P. value < 0.001). The AUC of thrombocytopenia (platelets count below 140 x 103 cell/cumm) in detecting mortality was 0.830 (95% CI: 0.748-0.913; P. value <0.001), with sensitivity of 86.8% and specificity of 84.3%.

Conclusion: The frequency of thrombocytopenia in Sudanese COVID-19 patients was high. The development of thrombocytopenia was significantly associated with old age, DM, hypertension, renal diseases and lung disease and invasive ventilation. Moreover, thrombocytopenia was significantly correlated with mortality